Why Do We Need To Supplement?

We've made it to the last installment of The Seven, and while the articles in this series aren't necessarily ordered according to any particular hierarchy, I did intentionally choose the supplementation article to be the final installment.

Why? Because even if you perfectly adhere to every other practice in this series - eating nutrient-dense foods, nurturing your microbiome, etc - you'll inevitably still be left with some nutritional gaps that leave you shy of what would be considered "optimal" nutritional status. 

This vitamin and mineral supplementation protocol aims to fill those gaps.

How can it be that eating nutrient-rich, whole foods every day can still leave us with gaps in our nutrition? Well, some of the contributing factors are new to modernity and some are as old as our species.       

What Does Soil Have To Do With It? 

It sounds trite to say it, but the foods produced by our modern large-scale supply chains are not at all the same as those our hunter-gatherer ancestors ate. Analysis shows that modern foods are not nearly as nutritious as those that grow in the wild, and that's largely because of the soil these foods are grown in.

Minerals have been stripped from our soils by years of farming the same plots of earth over and over. Farmers are able to add NPK (nitrogen-phosphorus-potassium) fertilizer to depleted soil and yield big beautiful plants, but these plants will not contain all the minerals they would have absorbed growing in truly wild, nutrient-rich soil.  

Organic farming practices are a lot better for returning nutrients to the soil, and a number of studies have shown organic produce to frequently be more nutritious than the non-organic equivalent. But farming itself is the core issue here, and even the best organic soil practices are going to yield foods that are significantly less nutrient-rich than those grown in the wild. 

Deficient vs Adequate vs Optimal

There was likely never a point in human history, or animal history for that matter, where an individual was perfectly nourished in every way. The reality is "optimally nourished" is extremely difficult, if not impossible, to achieve via foods alone (even if those foods are wild-harvested).

That being said, I think it is possible to get adequate levels of every essential nutrient via foods alone - but even this is still extremely difficult to do and studies have repeatedly shown that very few of us actually achieve this. Even if we were only looking at addressing deficiency, nearly all of us would benefit from supplementation. But as you might sense, the practices outlined below are aiming for a distinctly higher bar.

Deficiency, in this context, means that one or more essential vitamins or minerals are present in levels inadequate to support baseline metabolic function. For some nutrients, the adequate/non-deficient level effectively is the optimal level. That is to say, there's not really anything to be gained by consuming more of the nutrient than is needed to address a deficiency.

For other nutrients though, including many on the recommendations list below, there is quite a lot to be gained from consuming these nutrients in levels higher than those required to address a deficiency. Consuming higher levels of certain nutrients can help the body build greater metabolic resilience, resistance to disease and mental/physiological performance. This is what most of the recommendations in the section below are intended to realize.

Unhindered Metabolic And Endocrine Function

This "benefits" section perplexed me for a while. How does one go about framing the benefits of a practice that touches - literally - every single process in the human body?

Some of the nutrient-specific benefits are described in the implementation section below, but even these lists are far from comprehensive. When a nutrient is essential for hundreds of metabolic processes, the list of "benefits" from addressing a deficiency tends to be pretty long.

So after some deliberation, I couldn't think of a better way to summarize the positive impacts of this practice than this:  

Our metabolic and endocrine processes are the biochemical ground on which everything we care about, biologically-speaking, stands. Well-informed supplementation allows these processes to function efficiently and without impediment.

Essential Supplements: Implementation

Why Multivitamins Don’t Cut It

Looking at the (admittedly lengthy) list of vitamins and minerals above, you might be thinking “why can’t I just take a multivitamin?”

Unfortunately, even the best and most expensive multivitamins will not use the ideal bioavailable forms I’ve listed for each of these vitamins and minerals (generally, due to cost) - and they certainly won’t all be in the dosages I’ve recommended (both a cost and space consideration).

Fat soluble vitamins and essential fatty acids need to come in oil form to be absorbed and utilized, not in powder form as you see in almost every multivitamin. B12 is best absorbed sublingually. 800mg of magnesium and 1000g of vitamin C are not going to fit into a multivitamin...

These are just a few of the dozens of reasons I could cite that even the best multivitamins aren’t going to deliver the same quality of nutrients as taking them individually.

Should I Get Blood Tested?

It could be the case that your serum levels of some of these nutrients are already towards the upper end of the “optimal” range and supplementing with those particular vitamins or minerals isn’t going to do a lot for you.

The only way to know this, of course, is to get blood tested regularly - once every 3-4 months is probably the right interval if you’re going to use this data to inform your supplementation practices.

Getting blood tested regularly is expensive and time-consuming, whereas supplementing comprehensively is comparatively inexpensive and time-efficient. Given this reality, I get blood tested about once a year on average (more for insight into my hormone levels and other metabolic markers, than nutrient levels), and follow the supplementation regimen laid out here, preferring to be confident my serum levels are where I want them to be, even if I’m peeing out some quantity of the supplements I consume.

Fat Soluble Vitamins

1. Vitamin A (as retinol)

Vitamin A is probably best known for its role in the production of rhodopsin (a protein in our eyes critical for low-light vision), but the reality is vitamin A is involved in a huge number of essential processes in the body. Here are some of the highlights: immune function, embryo development, bone metabolism, red blood cell production and gene transcription. [1][2]

Recommendation: 2000-4000mcg/day via a fish liver oil concentrate like this one.

For vegans it’s a bit trickier. Beta-carotene (found in carrots, etc) is similar to the bioactive form if vitamin A and can be converted into the bioactive form, but this process is extremely inefficient (you have to consume about 24000mcg of Beta-carotene to get 2000mcg of bioactive vitamin A. It’s do-able, but not quite as convenient). If you go the vegan route, you’d take about 3 of these capsules each day.

2. Vitamin D3 (cholecalciferol)

Vitamin D regulates the expression of over 1000 genes (about 1/24 of our total). Deficiency in vitamin D has been correlated with DNA damage and telomere shortening, two primary indicators of biological aging. Vitamin D is also converted into calcitriol, the body’s primary hormone for regulating calcium levels in the blood and cells. [3][4]

Recommendation: 5000IU per day via a cholecalciferol supplement. I use this one from Jarrow.

Our body can convert cholesterol into cholecalciferol when exposed to sufficient UV-B radiation from the sun, but few of us regularly get enough sun to keep serum levels in the ideal range. Some studies have shown 70% of individuals tested to be below adequate levels.

3. Vitamin K2 (as MK7)

Vitamin K is required for synthesis of several essential proteins, including many of the proteins responsible for blood clotting. It’s also centrally involved in the binding of calcium in bones and other tissues. [5][6]

Recommendation: 50-100mcg/day via a MK7-form supplement like this one from Jarrow.

Water Soluble Vitamins

4+5. B12 (as methylcobalamin) + B9 (as folinic acid)

These two come as a pair because they so commonly work in tandem in the body. B12 and B9 play a critical role in DNA methylation (which facilitates both DNA replication and expression) and function as well as fatty acid synthesis. B12 and B9 also work together to play a key role in neurological function. Having either one of the two present without sufficient amounts of the other can produce neurological issues, so the common practice of taking a B12 supplement by itself is not a wise one.[7]

Recommendation: 3000-5000mcg/day of B12 via a methylcobalamin supplement like this one.

800mcg/day of B9 via folinic acid.

6. Vitamin C (as buffered ascorbic acid)

Vitamin C is probably best known for its essential role in lymphocyte (immune cell) production and function. Ascorbic acid is also necessary for the synthesis of glutathione, one of our body’s primary endogenous antioxidant enzymes that protects our various tissues from oxidative damage. [8]

Recommendation: 1000mg/day of buffered ascorbic acid. Recommended product here.

Minerals

7+8+9. Copper (as chelated copper) + Selenium + Iodine (as kelp powder)

All three of these minerals act as cofactors for a huge number of enzymes in the body, meaning those enzymes will not function if these minerals are not available in adequate levels. Iodine deficiency is both particularly common and consequential. Iodine is used in the synthesis of several thyroid hormones, and deficiency in iodine can lead to suppressed thyroid function (and thus, suppressed energy metabolism and a long list of other downstream functions). [9]

All three of these minerals are great examples of nutrients that were formerly abundant in our soils and our foods, but have been largely stripped out (and not replaced) by modern large-scale farming.

Recommendation: 2mg/day of chelated copper (product recommendation), 200mcg/day of selenium (product recommendation) and 200-300mcg/day of iodine via kelp powder (product recommendation)

10. Lithium (as lithium oroate)

Lithium is a particularly interesting case. We’ve known that lithium is critical to healthy neurological function - it upregulates the production of several neurotrophins (proteins essential for neuron growth and function) - but we haven’t had a clear picture of the consequences of deficiency (and in many ways, we still don’t).

There have been a handful of recent studies that suggest lithium deficiency might be correlated with a number of undesirable psychological and emotional traits including violence and impulsiveness. For what it’s worth, in my own personal n=1 study with lithium, I noticed a marked improvement in emotional stability within a few weeks of starting supplementation. [11]

Recommendation: 5-10mg/day via lithium oroate. I use this one from Klaire Labs.

11. Magnesium (as chelated magnesium)

What doesn't magnesium do in the body? There are few nutrients involved in more metabolic processes than magnesium.

It’s the movement of magnesium (and calcium) through ion channels in the membranes of our muscle cells that cause these tissues to contract when we want them to. Because of this, magnesium gets used at a high rate in the body and most people hover in less-than-ideal range without supplementation.

Addressing low magnesium levels via supplementation will commonly result in headaches and muscle tension disappearing, and sleep improving.

In addition to its role in muscle contraction, magnesium is also a cofactor for over 300 enzymes, including all enzymes using ATP (the metabolism's primary energy source). [12]

Recommendation: 500-800mg/day via a chelated magnesium like this one.

Essential Fats

Our body has a long list of fatty acids essential to the functioning of its many systems, but Omega 3/6/9 fatty acids are the only ones our body cannot produce on its own, meaning we have to consume them via our diet.

Omega 6 and 9 fatty acids are abundant in common foods like vegetable oils, so it’s rarely necessary to supplement with these. Omega 3 (DHA and EPA being the most important) are comparatively rare in our foods, meaning supplementation is usually necessary.

DHA and EPA are used in membrane formation in most cells in the body, but their role is particularly important in the brain, where DHA is the most abundant fatty acid. Studies have shown DHA supplementation to enhance memory, offer neuroprotection and slow the progression of neurological diseases like Alzheimer’s. [13]

Recommendation: 1g of EPA/DHA per day via small, deep-water fish like anchovies and sardines. Nordic Naturals is a brand that always performs well in 3rd party quality and purity testing.

For vegans, EPA and DHA are available via algae, but it is generally in the range of 2-3x as expensive to get the same dose. Nordic Naturals makes the most reputable algae-based EPA/DHA product also.

Foods like flax and chia that are often cited as plant-based sources of Omega 3s contain ALA, not DHA or EPA. While ALA can be converted to EPA and DHA, it’s an inefficient process and you’d have to consume a TON of flax oil to get the equivalent of 1g of EPA/DHA (which I don’t recommend due to phytoestrogens in flax oil) . Algae supplements are easily the best vegan option here.

Metabolism Support

13. Creatine Monohydrate

Many people will associate creatine with dudes lifting weights in a vanity-fueled effort to get “shredded” - and while creatine is definitely this, it’s also an essential compound our bodies manufacture that’s used for ATP synthesis in literally every cell in our body.

While our bodies will usually produce creatine in levels sufficient to keep the ship running, there is a lot of evidence that there is a lot to be gained in consuming additional creatine via our diet. Creatine is present in red meat, but unless you’re consistently eating a steak or two a day, you’d likely benefit from supplementation.

The benefits of creatine supplementation for athletic performance have been well documented, but it’s the improvements in brain function that I find the most compelling. A handful of studies have shown improvements in various measures of cognitive function when subjects are supplementing with creatine. [14]

Recommendation: 5g/day of creatine monohydrate.

How Much Will This Cost?

If you've made it to the end of this rather lengthly list of supplements and are wondering "How much does this cost!?!" - you're not alone.

The good news is, it's almost certainly less than you think. There's an up front cost of buying in quantities that will last several months, but when you break down the actual per/day cost it comes to a whopping $ 1.82/day, or about $55/mo. 

Get A Pill Organizer

One final suggestion: Trust me on this one, opening 12 supplement bottles and dispensing pills is not something you want have to do every day. Invest in a pill organizer like this one and open 12 pill bottles once a week instead. 

[1] https://www.sciencedirect.com/science/article/abs/pii/0012160686901442

[2] https://www.sciencedirect.com/science/article/abs/pii/S0378111903011296

[3] https://www.sciencedirect.com/science/article/pii/S0083672915000631

[4] https://link.springer.com/article/10.1007/s00394-015-1095-7

[5] https://jasn.asnjournals.org/content/28/6/1717? 

[6] https://lpi.oregonstate.edu/mic/vitamins/vitamin-K

[7] https://www.researchgate.net/profile/Aparna_Varma/publication/322438518_Folic_acid_vitamin_B12_and_DNA_methylation_An_update/

[8] https://www.mdpi.com/2076-3921/7/3/41

[9] https://www.liebertpub.com/doi/full/10.1089/thy.2018.0305

[10] https://pubmed.ncbi.nlm.nih.gov/19523343/

[11] https://www.sciencedirect.com/science/article/abs/pii/S030698771600044X

[12] https://www.sciencedirect.com/science/article/abs/pii/S0899900715004062

[13] https://www.cambridge.org/core/journals/nutrition-research-reviews/article/dietary-dha-and-health-cognitive-function-ageing/1DC26922C905D4C150EF21282C9AA054

[14] https://www.tandfonline.com/doi/abs/10.1080/17461391.2018.1500644